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June 16, 1994New England Journal of Medicine

The Epidemiology of Tuberculosis in San Francisco -- A Population-Based Study Using Conventional and Molecular Methods

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Authors

PSPeter M. SmallPHPhilip C. HopewellSSSamir P. Singh

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Overview

Population-based study reveals high rates of recent tuberculosis transmission among urban patients, indicating standard contact tracing fails to identify most community transmission links.

Key Points

  • Evaluate transmission dynamics and risk factors for active tuberculosis in an urban population by combining conventional contact tracing with molecular strain typing.
  • Analyzed Mycobacterium tuberculosis isolates from all reported tuberculosis registry patients during 1991 and 1992 (N=473).
  • Applied restriction-fragment-length polymorphism (RFLP) analysis to identify identical strain clusters alongside demographic, clinical, and epidemiological data.
  • DNA fingerprinting identified 44 strain clusters representing 191 patients with active disease from recent infection, whereas conventional contact tracing identified links in only 10% of these cases.
  • In patients under 60 years of age, independent risk factors for cluster membership were birth in the United States (OR 5.8; P < 0.001), Hispanic ethnicity (OR 3.3; P = 0.02), Black race (OR 2.3; P = 0.02), and an AIDS diagnosis (OR 1.8; P = 0.04).

Cite This Study

Small et al. (1994) studied this question.

synapsesocial.com/papers/6a03a6ac6aa73b130d856035https://doi.org/10.1056/nejm199406163302402
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